US6656132B1 - Endoscopic tissue collecting instrument - Google Patents
Endoscopic tissue collecting instrument Download PDFInfo
- Publication number
- US6656132B1 US6656132B1 US09/722,730 US72273000A US6656132B1 US 6656132 B1 US6656132 B1 US 6656132B1 US 72273000 A US72273000 A US 72273000A US 6656132 B1 US6656132 B1 US 6656132B1
- Authority
- US
- United States
- Prior art keywords
- inner needle
- tissue
- outer sheath
- distal end
- retaining recess
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
- 238000005520 cutting process Methods 0.000 claims abstract description 23
- 238000003780 insertion Methods 0.000 description 11
- 230000037431 insertion Effects 0.000 description 11
- 238000001574 biopsy Methods 0.000 description 3
- 210000004185 liver Anatomy 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 239000002184 metal Substances 0.000 description 2
- 210000000496 pancreas Anatomy 0.000 description 2
- 239000011347 resin Substances 0.000 description 2
- 229920005989 resin Polymers 0.000 description 2
- 230000000717 retained effect Effects 0.000 description 2
- 229910001220 stainless steel Inorganic materials 0.000 description 2
- 239000010935 stainless steel Substances 0.000 description 2
- BFKJFAAPBSQJPD-UHFFFAOYSA-N tetrafluoroethene Chemical group FC(F)=C(F)F BFKJFAAPBSQJPD-UHFFFAOYSA-N 0.000 description 2
- 230000008878 coupling Effects 0.000 description 1
- 238000010168 coupling process Methods 0.000 description 1
- 238000005859 coupling reaction Methods 0.000 description 1
- 229920002457 flexible plastic Polymers 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 210000000056 organ Anatomy 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Instruments for taking body samples for diagnostic purposes; Other methods or instruments for diagnosis, e.g. for vaccination diagnosis, sex determination or ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/0233—Pointed or sharp biopsy instruments
- A61B10/0266—Pointed or sharp biopsy instruments means for severing sample
- A61B10/0275—Pointed or sharp biopsy instruments means for severing sample with sample notch, e.g. on the side of inner stylet
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Instruments for taking body samples for diagnostic purposes; Other methods or instruments for diagnosis, e.g. for vaccination diagnosis, sex determination or ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B2010/0225—Instruments for taking cell samples or for biopsy for taking multiple samples
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Instruments for taking body samples for diagnostic purposes; Other methods or instruments for diagnosis, e.g. for vaccination diagnosis, sex determination or ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/04—Endoscopic instruments, e.g. catheter-type instruments
- A61B2010/045—Needles
Definitions
- the present invention relates to an endoscopic tissue collecting instrument suitable for use typically in a biopsy of the pancreas and the liver by being inserted into and removed from a treatment instrument insertion channel in an endoscope.
- FIG. 10 shows the distal end portion of a Menghini needle used as an endoscopic tissue collecting instrument. It comprises a rod-shaped needle shaft 80 having a pointed end 81 and a tissue retaining recess 82 formed in the lateral side of an area close to the needle end 81 and into which an excised tissue specimen 101 is retained.
- a cannula or outer sheath 90 is fitted over the needle shaft 80 to be capable of moving back and forth along the longitudinal axis and it has an annular blade 91 formed on the inner circumference of the distal end for cutting off the tissue retained in the recess 82 .
- the endoscopic tissue collecting instrument Before passage into the treatment instrument insertion channel of an endoscope, the endoscopic tissue collecting instrument is passed through a guide tube (not shown) typically made of a tetrafluoroethylene resin to prevent the needle tip 81 from damaging the insertion channel.
- a guide tube typically made of a tetrafluoroethylene resin to prevent the needle tip 81 from damaging the insertion channel.
- a problem with the above-described endoscopic tissue collecting instrument is that the depth of the tissue retaining recess 82 is inevitably much smaller than the diameter of the outer sheath 90 , often causing a failure to collect an adequate amount of the tissue specimen.
- An object, therefore, of the present invention is to provide an endoscopic tissue collecting instrument with which an adequate amount of the tissue specimen can be easily collected without increasing the diameter of the outer sheath.
- the tissue accommodated in the outer sheath via a tissue retaining recess formed in its lateral side can be used as a specimen for biopsy.
- the collected tissue specimen has the largest size that can be expected from the given diameter of the outer sheath. Hence, an adequate amount of the tissue specimen can be easily collected without increasing the diameter of the outer sheath.
- An endoscopic tissue collecting instrument of a preferred embodiment includes:
- an outer sheath including:
- tissue retaining recess formed in a lateral side of an area close to the blade portion
- a cutting blade formed at a distal end of the inner needle, for cutting off a tissue entering the tissue retaining recess
- the inner needle can be manipulated from an operator side to move back and forth between two positions, one being where the distal end of the inner needle is drawn into the outer sheath such that it does not close the tissue retaining recess and the other being where it protrudes from the distal end of the outer sheath.
- the distal end of the inner needle may be in the form of a tube, and the cutting blade may be formed on an inner periphery of the tube.
- the endoscopic tissue collecting instrument may further include an aspiration channel that communicates with the tissue retaining recess at a distal end thereof and which extends to a basal end of the outer sheath.
- the aspiration channel may be formed in the inner needle, and a connection socket for establishing connection to an aspirating device may be provided at a basal end of the inner needle.
- the tissue retaining recess may be a cutout formed in the lateral side of said outer sheath.
- the endoscopic tissue collecting instrument may further include a guide tube through which the outer sheath is passed to be capable of moving back and forth along the longitudinal axis.
- the needle tip of the inner needle may also serve as the cutting blade.
- FIG. 1 is a longitudinal section showing the general layout of an endoscopic tissue collecting instrument according to the first embodiment of the invention
- FIG. 2 is a perspective view showing the distal end portion of the inner needle according to the first embodiment of the invention
- FIG. 3 is an exterior view showing how the endoscopic tissue collecting instrument according to the first embodiment of the invention is used as an attachment to a soft endoscope;
- FIG. 4 is a longitudinal section showing the distal end portion of the endoscopic tissue collecting instrument as it is in the first phase of use;
- FIG. 5 is a longitudinal section showing the distal end portion of the endoscopic tissue collecting instrument as it is in the second phase of use;
- FIG. 6 is a longitudinal section showing the distal end portion of the endoscopic tissue collecting instrument as it is in the third phase of use;
- FIG. 7 is a longitudinal section showing the distal end portion of the endoscopic tissue collecting instrument as it is in the fourth phase of use;
- FIG. 8 is a longitudinal section showing the distal end of an endoscopic tissue collecting instrument according to the second embodiment of the invention.
- FIG. 9 is a longitudinal section showing how the endoscopic tissue collecting instrument is used without a guide tube.
- FIG. 10 is a longitudinal section showing the distal end portion of a conventional endoscopic tissue collecting instrument in a use mode.
- FIG. 1 shows the general layout of an endoscopic tissue collecting instrument according to a first embodiment of the invention.
- a cannula or outer sheath 20 is formed as a round pipe having a constant diameter throughout its length.
- the outer sheath 20 has an annular blade portion 21 formed on the outer periphery of its distal end and directed forwards.
- a tissue retaining recess 22 for retaining a tissue specimen in its interior is formed in the lateral side of the outer sheath 20 in an area immediately behind the blade portion 21 .
- the tissue retaining recess 22 is formed by making a cutout in the lateral side of the pipe-like outer sheath 20 to a depth almost equal to its radius.
- a pipe-like inner needle 10 having a circular section is passed into the outer sheath 20 over the substantially entire length of the outer sheath 20 so that it is capable of moving back and forth along the longitudinal axis.
- the distal end portion of the inner needle 10 is skived (cut at an angle) as in the case of a syringe so that the projecting end provides a needle tip 11 that is pointed forward.
- the distal end portion of the inner needle 10 is not simply skived but a sharp cutting blade 12 which is formed on the entire inner circumference.
- the needle tip 11 is continuous with the cutting blade 12 .
- the inner needle 10 can be manipulated by the operator to move back and forth between two positions, one being indicated by the solid line in FIG. 1 where its distal end is drawn into the outer sheath 20 such that it does not close the tissue retaining recess 22 and the other being indicated by the two-dotted chain line where it protrudes from the distal end of the outer sheath 20 .
- both the outer sheath 20 and the inner needle 10 are formed of a metal pipe; if it is to be used with a soft endoscope having a flexible part to be inserted into a body cavity, the two members may be formed of a flexible plastic material or a metal pipe (e.g. a stainless steel pipe) that is sufficiently thin-walled to have flexibility.
- a metal pipe e.g. a stainless steel pipe
- the outer sheath 20 may be sized to have an outside diameter of about 1.0 mm and an inside diameter of about 0.9 mm whereas the inner needle 10 may be sized to have an outside diameter of about 0.9 mm and an inside diameter of about 0.8 mm. With these dimensions, both members can be bent smoothly to permit use with a soft endoscope.
- the inner needle 10 extends farther beyond the basal end of the outer sheath 20 toward the operator, and its basal end is fitted with a suction line socket 14 for establishing connection to an aspirating device such as a syringe.
- an aspirating device such as a syringe.
- a grip 23 attached to the basal end of the outer sheath 20 (the end which is closer to the operator) is made of a rigid material, and fitted with a first manual lock screw 24 for pressing and fixing the inner needle 10 .
- the outer sheath 20 and the inner needle 10 move back and forth as a unit. If the first lock screw 24 is loosened, the outer sheath 20 and the inner needle 10 can be moved back and forth independently of each other.
- Indicated by 30 is a guide tube that protects the treatment instrument insertion channel of a soft endoscope from being damaged by the needle tip 11 while the endoscopic tissue collecting instrument is inserted into or removed from the insertion channel.
- the guide tube is typically made of a tetrafluoroethylene resin.
- a support member 31 is securely coupled to the basal end of the guide tube 30 and it has a mount socket 32 with a female thread for establishing firm coupling to the treatment instrument insertion port of the endoscope.
- the support member 31 is also furnished with a second manual lock screw 33 that is capable of fixing the grip 23 in a desired position relative to the support member 31 .
- FIG. 3 shows the endoscopic tissue collecting instrument as it has been set on a soft endoscope 40 .
- Reference numeral 41 designates the part which is encased in a flexible tube and which is to be inserted into a body cavity; 42 is the manipulating section; 43 is a connector to a video processor and light source unit; 44 is the treatment instrument insertion port.
- the guide tube 30 is passed into the treatment instrument insertion channel of the endoscope and the mount socket 32 is held in engagement with the treatment instrument insertion port 44 .
- the operator can manipulate the inner needle 10 to move back and forth without moving the outer sheath 20 . If the second lock screw 33 is loosened and the operator manipulates the grip 23 to move it back and forth, the outer sheath 20 can accordingly be moved back and forth together with the inner needle 10 .
- FIGS. 4-6 show how a tissue specimen for biopsy is collected from the liver, the pancreas or other organ by means of the endoscopic tissue collecting instrument according to the embodiment described above.
- the distal end of the inner needle 10 is allowed to protrude from the distal end of the outer sheath 20 so that the needle tip 11 is pierced into the tissue 100 . Since the outer sheath 20 has the blade portion 21 at the distal end, the tissue collecting instrument can be smoothly pierced into the tissue.
- the inner needle 10 is pulled toward the operator until the tissue retaining recess 22 becomes exposed and vacuum is drawn toward the operator via the aspiration channel 13 as shown in FIG. 5 .
- the tissue specimen 101 which is a portion of the tissue 100 is aspirated into the outer sheath 20 via the tissue retaining recess 22 .
- the thickness of the collected tissue specimen is exactly the same as the inside diameter of the outer sheath 20 and it is the largest size that can be secured with the given diameter of the outer sheath 20 .
- the inner needle 10 is pushed forward as shown in FIG. 6, whereupon the tissue specimen 101 is cut off from the rest of the tissue 102 by the blade 12 of the inner needle 10 sliding along the inner surface of the outer sheath 20 .
- the severed tissue specimen 101 is placed within the tissue retaining recess 22 .
- the tissue specimen 101 of a large size can be easily collected. Since the inner needle 10 slides within the outer sheath 20 , it is smoothly pushed forward with a small sliding resistance. As is clear from FIG. 6, the tissue specimen 101 is collected within the inner needle 10 such that some part of the tissue specimen 101 is slightly compressed.
- the cutting blade 12 is formed at the distal end of the inner needle 10 on substantially all of its inner periphery, there is no limitation regarding a rotational position of the inner needle 10 relative to the outer sheath 20 .
- the instrument may be used as shown in FIG. 7, that is, the positional relationship shown in FIG. 6 which concerns the rotation of the inner needle 10 relative to the outer sheath 20 may be reversed by 180 degrees as shown in FIG. 7 .
- the aspiration channel 13 may be formed in other areas than the bore of the inner needle 10 , such as the boundary between the inner needle 10 and the outer sheath 20 .
- the inner needle 10 may be formed as a solid rod that does not permit vacuum drawing as shown in FIG. 8 .
- the guide tube 30 is not an essential component.
- the tissue collecting instrument of the invention may be directly inserted into or removed from the treatment instrument insertion channel 50 with the distal end of the inner needle 10 being drawn into the outer sheath 20 .
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Medical Informatics (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Pathology (AREA)
- Molecular Biology (AREA)
- Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
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- Endoscopes (AREA)
Abstract
Description
Claims (11)
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP33691599A JP2001149374A (en) | 1999-11-29 | 1999-11-29 | Tissue-collection instrument for endoscope |
JPP.11-336915 | 1999-11-29 |
Publications (1)
Publication Number | Publication Date |
---|---|
US6656132B1 true US6656132B1 (en) | 2003-12-02 |
Family
ID=18303820
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/722,730 Expired - Fee Related US6656132B1 (en) | 1999-11-29 | 2000-11-28 | Endoscopic tissue collecting instrument |
Country Status (4)
Country | Link |
---|---|
US (1) | US6656132B1 (en) |
JP (1) | JP2001149374A (en) |
DE (1) | DE10059264A1 (en) |
DK (1) | DK200001762A (en) |
Cited By (193)
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US20030083684A1 (en) * | 2001-10-26 | 2003-05-01 | Cesarini Peter M. | Reciprocating rotary arthroscopic surgical instrument |
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US20110190662A1 (en) * | 2008-10-01 | 2011-08-04 | Beacon Endoscopic Corporation | Rapid exchange fna biopsy device with diagnostic and therapeutic capabilities |
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DK200001762A (en) | 2001-05-30 |
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